How much rates vary
Facilitymedian $2,188 · 10th to 90th $832 to $5,370Professionalmedian $339 · 10th to 90th $27 to $692
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $707.95 Median $2,754.23 Typical High $6,918.31 | Facility | None | $707.95 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $645.65 | Professional | None | $295.12 | $512.86 | $645.65 |
BCBS Texas Setting Facility Modifier None Typical Low $1,380.38 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,380.38 | $2,454.71 | $5,248.07 |
BCBS Texas Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $741.31 | Professional | None | $338.84 | $537.03 | $741.31 |
Christus Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,187.76 | Facility | None | $602.56 | $1,513.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $776.25 | Professional | None | $380.19 | $512.86 | $776.25 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $5,495.41 | Professional | None | $4,168.69 | $4,168.69 | $5,495.41 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $1,122.02 Typical High $4,786.30 | Facility | None | $363.08 | $1,122.02 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $645.65 | Professional | None | $295.12 | $512.86 | $645.65 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $112.20 Typical High $588.84 | Professional | None | $20.89 | $112.20 | $588.84 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $1,513.56 Typical High $4,466.84 | Facility | None | $501.19 | $1,513.56 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $776.25 | Professional | None | $380.19 | $512.86 | $776.25 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,235.94 | $6,606.93 |
United Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $691.83 | Professional | None | $281.84 | $446.68 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $147.91 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $60.26 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $380.19 Typical High $457.09 | Professional | 54 · Surgery only | $223.87 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $44.67 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $29.51 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $354.81 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $208.93 | $354.81 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $147.91 | $251.19 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $60.26 | $102.33 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $380.19 Typical High $457.09 | Professional | 54 · Surgery only | $223.87 | $380.19 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $44.67 | $75.86 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $29.51 | $51.29 | $60.26 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $354.81 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $208.93 | $354.81 | $426.58 |
Where Texas sits
The same service costs 4.7 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 51st of 51
$355
AK $1,660TX $355
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.